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Study aims to improve early detection of osteoarthritis after knee injury

Biomedical engineering researcher Janet Ronsky develops non-invasive technique to spot subtle changes in cartilage function
December 21, 2016
University of Calgary researcher Janet Ronsky, front right, uses dual-fluoroscopy to test for signs of early osteoarthritis. Photo by Don Molyneaux for the University of Calgary

University of Calgary researcher Janet Ronsky, front right, uses dual-fluoroscopy to test for signs of early osteoarthritis. Photo by Don Molyneaux for the University of Calgary

A tumble on the ski hill or a slip on the sidewalk can prove to be traumatic on the knees short-term and potentially long-term. Suffering a knee injury increases the likelihood of developing osteoarthritis. Now a researcher in the Schulich School of Engineering at the University of Calgary is embarking on a new study to change the negative outcomes associated with knee injuries with new diagnostic techniques that will monitor the body for changes immediately following an injury. 

“Currently, the gold standard of diagnosis is to use X-ray on knee injuries,” says Janet Ronsky, AITF iCORE Strategic Chair, Advanced Diagnostics and Devices and professor of mechanical and manufacturing engineering. “However, that only works once physical breakdown of cartilage can be viewed. At that point we have much less chance of changing the progression the disease.”

Understanding mechanics and disease progression

Ronsky is looking to find an in vivo marker based on cartilage function in the body that can assist in predicting the risk of early post-traumatic osteoarthritis. In vivo refers to the dynamic changes that take place as the body responds to an injury.

“We will not open people up or do a biopsy, this is not an invasive procedure,” she adds. “Essentially what we are doing is to come up with a mechanical marker or a way to diagnose people early for post-traumatic osteoarthritis.”

Knee osteoarthritis is a leading cause of disability and rupture of the anterior cruciate ligament (ACL) is a major risk factor for onset and development of post-traumatic osteoarthritis.

Ronsky was recently awarded close to $600,000 in funding from the Canadian Institutes of Health Research (CIHR) to perform a multi-year study tracking healthy individuals and those with ACL injuries.

“What makes this study unique is that we are examining how the cartilage degrades over time,” adds Ronsky. “We hope to quantify joint mechanics and cartilage biology outcomes in ACL deficient subjects and healthy subjects. It will lead us to better understand the disease and mechanisms behind it.” 

Research based at Centre for Mobility and Joint Health 

Ronsky’s interdisciplinary research team is based at the Centre for Mobility and Joint Health (MoJo) located at the University of Calgary's Cumming School of Medicine. The new facility, housed and operated by the university’s McCaig Institute for Bone and Joint Health, features state-of-the-art imaging, movement assessment, and diagnostic equipment.

For this study, researchers will track 72 individuals with ACL deficiencies and 72 healthy individuals as the control group. They will utilize Dual Fluoroscopy and MRI to create a 3-D construction or image of the knee.

“We will have a participant do a dynamic task like walking or standing on one leg, which will load their joint,” explains Ronsky. “We take fast images and we can see how the bones are moving together. For the standing case, if the rate the bones comes together is faster, this indicates that the cartilage is not as healthy. This is part of the individual cartilage 'signature' or mechanical marker. The 'signatures' between healthy and injured are very different.”

Detect signs of degeneration more quickly

Ronsky believes that this research will make a difference in people’s lives and in receiving medical treatment or intervention.

“If we can capture how quickly the degeneration is occurring we can identify people as high versus lower risk and it can then be used to target and evaluate therapeutic techniques and to help provide the right treatment at the right time,” she says.

If you are interested in participating in the study, please contact jlronsky@ucalgary.ca before Jan. 31, 2017.

Janet Ronsky's research group focuses on understanding the links between musculoskeletal system structure, joint mechanics, dynamic joint function, neuromotor control and joint injuries and diseases such as Osteoarthritis and Scoliosis. Medical imaging, experimental and numerical modeling and simulation approaches are applied to develop novel diagnostic and treatment devices and techniques to enhance health care. Ronsky is a Professor at the Schulich School of Engineering and Adjunct Professor, in the Faculty of Kinesiology and Cumming School of Medicine, University of Calgary. She is also the AITF iCORE Strategic Chair in Advanced Diagnostics and Devices. 

The University of Calgary’s multidisciplinary Engineering Solutions for Health: Biomedical Engineering research strategy is focused on developing solutions for pressing health challenges in disease and injury prevention, diagnosis and treatments. We are also applying systems engineering principles to continuously improve the health system.